Monthly Archives: February 2016

Healthcare Services Platform Consortium and the Center for Medical Interoperability aim to advance development of innovative clinical applications and services to improve patient care

SCOTTSDALE, Ariz. and NASHVILLE, Tenn. (February 29, 2016) – The Healthcare Services Platform Consortium (HSPC) and the Center for Medical Interoperability are collaborating on technical initiatives to enable clinical applications to easily and securely access health information. The two provider-led, nonprofit organizations will leverage complementary strengths to develop compatible architectures and platforms to facilitate the flow of data from the patient to clinical applications and services that can enhance care.

Stan Huff, MD, chief medical information officer of Intermountain Healthcare and chairman of the HSPC Board, said, “HSPC and the Center are aligned in their goal to help people live the healthiest lives possible. Combining resources to create a consistent technical platform solution will benefit the entire industry and accelerate the availability of interoperable clinical applications and services.”

“There is a natural handoff between our work at the medical device and enterprise service levels, and HSPC’s platform for interoperable clinical applications. We look forward to working with HSPC to ensure we both get it right,” said Ed Cantwell, executive director of the Center for Medical Interoperability.

The Center serves as a cooperative R&D arm for health systems, guiding innovation and providing a vendor-neutral focal point to work with solution providers. It is enabling health systems with a platform that makes it easier and less expensive to share clinically rich data across medical devices and IT systems. HSPC is focused on developing a Service Oriented Architecture (SOA) platform for healthcare utilizing current cross-industry standards, healthcare-centric knowledge coupled terminology models based on the Clinical Element and HL7/CIMI models. Together, HSPC and the Center will leverage the unified voice of healthcare organizations to drive industry alignment and accelerate innovation and time to market.

“From the beginning, HSPC recognized the importance of provider leadership. The membership of HSPC, combined with that of the Center, represents a strong market force to achieve cross healthcare interoperability. Working closely with the Center, we will focus on addressing clinical and business needs that positively impact patient outcomes and the experience for all care providers,” said Oscar Diaz, chief executive officer of HSPC.

The HSPC will be demonstrating open SOA architecture applications during HIMSS’16 in the Interoperability Showcase (Booth #11954) and at the Intermountain Healthcare exhibit (Booth #1632). For a schedule of HSPC events at HIMSS’16, see www.HSPConsortium/HIMSS2016.

About the Center for Medical InteroperabilityThe Center for Medical Interoperability is a 501(c)(3) organization led by health systems to change how medical technologies work together. We aim to improve real-time information flow and make technology function seamlessly in the background so we can achieve the best possible outcomes for patients. Our members are committed to compelling change and improving patient safety, care quality and outcomes, and reducing clinician burden and waste. Learn more at www.center4mi.org.

About the Healthcare Services Platform Consortium

HSPC is a provider led, not-for-profit, multi-stakeholder, membership organization that is fostering an industry-wide collaborative for the development of an open Service Oriented Architecture (SOA) and an ecosystem of interoperable applications, knowledge, content and services. As part of the development of the healthcare SOA, HSPC is creating a federated model for multi-vendor RESTful web services, leveraging HL7ä, FHIRä resources and HSPC specified profiles.

Similar to iOS and Android, HSPC supports a marketplace model for plug-and-play healthcare applications leveraging the work at Intermountain Healthcare, LSU Health, the VA VistA Evolution initiative and others. The HSPC marketplace will support common services and models that providers and vendors can use to shorten development and implementation life cycles.

The Healthcare SOA will enable multiple collaborators to deliver different parts of a solution set that address workflow gaps within and between systems. This platform supports high-fidelity workflow models that support acute, ambulatory and patient-centered medical home needs. More information can be found at www.HSPConsortium.org.

Most everyone agrees that interoperability — enabling healthcare information to flow seamlessly between disparate devices and IT systems — would improve patient care and reduce costs. Yet despite all the new technologies and gadgets, there’s still a disconnect when it comes to actually being able to share health data.

One of the factors driving the interoperability challenge is that the different medical device and health IT manufacturers each have their own proprietary interface technology, so there’s no way to connect the disparate parts, said Kerry McDermott, vice president for public policy and communications at the Center for Medical Interoperability. Without a common interface — something akin to a USB cord — hospitals are forced to spend scarce time and money setting up each technology in a unique way.

Adding to the problem that there is no overarching architecture for creating interoperability. “In healthcare, we don’t have that blueprint for how the different pieces should fit together,” McDermott said.

Another problem has been the lack of standards. Unlike a two-by-four that really never varies, in healthcare you don’t always know what you’re getting. This is beginning to change, though, with groups like Integrating the Healthcare Enterprise. “IHE came up with all these standards and we adopted them,” said Daniel Pettus, vice president for IT sales for BD’s Medical Management Group.

BD has been working with Epic and Cerner to facilitate information flow between its infusion pumps and EHRs. “We haven’t seen any reluctance in the IT community to share information in order to expand the capability” said Pettus. The biggest barrier to interoperability, he said, is alignment — getting devicemakers and IT companies to talk with one another.

Pettus cited, by way of example, a medication order. In the past, clinicians would generate an order in the IT system and that order was filtered down to the nurse who interpreted it based on information in an infusion pump, creating the potential for errors to occur, he explained. With connectivity, every single order that’s generated in the IT system must match the information in the infusion pump. “It’s a wonderful thing when it happens because, for the first time, you can guarantee that the order generated upstream by the doctor really matches” the information at the point of care, he said, adding, “That’s just not the case today.”

EHR vendors have also expressed frustration with the lack of interoperability, made more glaring with the shift to electronic health records. According to one study, 70% of physicians are spending less time with patients because of the demands of electronic record entry. The problem spurred athenahealth to launch a ‘Let Doctors Be Doctors’ campaign last October.

McDermott understands that frustration. “Hospitals and health systems don’t want to pay for things that don’t work together in a plug-and-play way, because it’s not good for patients,” she said. “There are absolute implications for patient safety, clinical care outcomes, clinician fatigue. We’re exhausting our workforce because they have to spend so much time troubleshooting the technology instead of having it function seamlessly in the background.”

CMI spun out of the West Health Institute early last year with the goal of creating a space for health systems and other stakeholders to meet and solve their interoperability challenges. The nonprofit is assembling a technology coalition of providers, devicemakers and IT vendors to develop the reference architecture for an interoperability platform, as well as medical device and enterprise interfaces to the platform.

In addition, CMI is establishing a centralized laboratory where engineers and other technical experts can work on shared challenges around getting medical devices, EHRs and IT systems to work in a plug-and-play way. The lab, located in Nashville, will also test and certify that devices and IT systems conform to the standardized architecture.

The goal is to ensure that the architecture is vendor-neutral and supports real-time one-to-many communications, two-way data exchange, plug-and-play integration of devices and systems, the use of standards and the highest level of security, McDermott said.

“At the end of the day, we’re trying to make it easier and less expensive for devices to talk to each other, for devices to talk to EHRs and to other systems that support patient care and clinical decisionmaking, not to mention consumer access to information,” she said.

For Cerner, interoperability involves working with competitors and industry partners to achieve more “meaningful connectivity using available standards and creating new ones where there are gaps,” said Cerner VIce President of Interoperability Bob Robke. “Our ongoing innovation includes an open platform that strengthens scope and service along the continuum of care, making it easier and faster for developers to create apps that meet the needs of people and their healthcare providers,” he said.​

The federal government has also been involved in the press for greater health interoperability. Last October, the Office of the National Coordinator for Health Information Technology released its final roadmap on interoperability. Guiding it are three overarching themes: the need to move to a value-based healthcare system that enables consumers to access and share personal health data; the need to eliminate obstacles, whether intentional or inadvertent, to data sharing across organizational boundaries; and the need for federally recognized interoperability standards.

And on Jan. 26, the Food and Drug Administration released draft guidance on design considerations for manufacturers of interoperable medical devices. Testing of devices should focus on the risks associated with interoperability, the potential for misuse and likely scenarios of events that could compromise patient safety.

In addition, the Senate’s Health, education, Labor & Pensions Committee last month unveiled legislation aimed at enhancing overall use and development of health IT. Among its proposals is the creation of a “trusted exchange network” for information sharing across health systems, EHR vendors and consumers. The bill would also create a set of “standardized data elements,” so that information could be easily entered and shared in patient registries.

The Improving Health Information Technology Act, S. 2511, is one of seven bills the Senate plans in answer to the House of Representative’s sweeping 21st Century Cures healthcare reforms bill.

Such initiatives notwithstanding, moving interoperability forward is a slow process and will take a concerted effort by the provider community, EHR vendors and devicemakers working together to tackle the obstacles. CMI hopes to provide that space. “You really need a place for all parties to say we should work with this architecture within the platform it creates, and everyone has access to the data in that platform and we can all compete on top of that,” McDermott said.

One of the most frustrating things patients deal with when interacting with the health system is attempting to share medical information among new specialists or facilities. From filling out the same form multiple times to potentially life-threatening delays in treatment due to crossed wires on prescriptions or referrals, patients may not know interoperability by name. But they certainly know its impact.

STORY HIGHLIGHTS

The Center for Medical Interoperability, a nonprofit organization, focuses on changing how medical technologies work together.

Organization expects to eventually employ as many as 100, including engineers and software architects who will work to improve the flow of information between medical devices, electronic health records and other information technology systems.

Once the Center for Medical Interoperability’s lease is finalized, the first office building at the OneC1TY health and technology-focused, mixed-use development would be fully leased.

A national nonprofit organization focused on changing how medical technologies work together is negotiating a lease on 16,000 square feet of space at the OneC1TY mixed-use development on Charlotte Avenue.

The location will house headquarters of the Center for Medical Interoperability, including its centralized lab. “It’s really going to be focused on innovation and being the R&D arm for health care,” said Kerry McDermott, vice president for public policy and communications for the center.

Over the summer, the center plans to relocate to OneC1TY near the 28th/31st Avenue Connector from temporary space in Green Hills.

Once its lease is finalized, the first office building at the health- and technology-focused mixed-use development will be fully leased. Other tenants of that 110,000-square-foot building will include anchor surgery practice Tennessee Orthopaedic Alliance, technology giant Microsoft and health information management company MediCopy Services Inc., with causal Italian restaurant concept Pastaria Nashville to occupy ground-floor retail space.

The Center for Medical Interoperability has a staff of 20, including a leadership team of six led by Executive Director Ed Cantwell. Eventually, the plan is to grow the technical staff to as many as 100, including engineers and software architects. They will work to improve the flow of information between medical devices, electronic health records and other information technology systems.

Ed Cantwell (Photo: Submitted)

“We think it should be easier and less expensive for devices to talk to each other and for devices to talk to electronic health records and other systems that support clinical decision-making, research and analytics,” McDermott said.

Originally part of the West Health Institute medical research organization in San Diego, the Center for Medical Interoperability was launched as an independent entity in August 2013 with $10 million in funding from the Gary and Mary West Foundation. Each member organization pays dues.

In April, the Center for Medical Interoperability announced a board of directors that includes five local health care executives.

At its lab, the center will handle testing and certification of health care technology to make sure it works in a plug-and-play way. “Our job is to make health care technology work for the caregiver, for the physician and the nurse, so they can do the best job taking care of their patients,” McDermott said.

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About the Center

The Center for Medical Interoperability is a 501(c)(3) cooperative research and development lab founded by health systems to simplify and advance data sharing among medical technologies and systems. We provide a centralized, vendor-neutral approach to performing technical work that enables person-centered care, testing and certifying devices and systems, and promoting the adoption of scalable solutions.

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Membership in the Center is an opportunity – to chart a course that will change our country forever, to touch countless lives now and for generations to come, to shape the future of care delivery. Learn More »